Information Collection

Extramural Researcher External Stakeholder Survey screenshots

IC 213297 under ICR 201409-0925-004 · OMB 0925-0712.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0712 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 4 Extramural Researcher External Stakeholder Survey screenshots	Form
4 Incentive Survey Distribution Screenshots Attachment 9 Incentive Distribution Form survey participants screenshots.pdf	Form
5 Extramural Researcher External Stakeholder Survey screen Attachment 19 Extramural Researcher External Stakeholder Survey Screenshots.pdf	Form and Instruction

IC Title:

Extramural Researcher External Stakeholder Survey screenshots

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	4	Incentive Survey Distribution Screenshots	Attachment 9 Incentive Distribution Form survey participants screenshots.pdf		Yes	Yes	Fillable Fileable
Form and Instruction	5	Extramural Researcher External Stakeholder Survey screenshots	Attachment 19 Extramural Researcher External Stakeholder Survey Screenshots.pdf		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 400

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	400	400
Annual IC Time Burden (Hours)	200	200
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.